한국인의 고관절(股關節)고정술(固定術)에 관한 임상적 관찰

Abstract

[한글]

Clinical Observation of Arthrodesed Patients in Korea

Seung Hwi Shim

Department of Medical Science, The Graduate School, Yonsei University

(Directed by Professor In Hee Chung, M.D.)

The arthrodesis of the hip is the only certain method for eliminating pain and

providing sability in young and middle aged adults. The first used arthrodesis in

old congenital dislocation was reported by Heusmer, Lampugnani, and Alert as early

as 1885 according to Nove-Joesearand.

The various papers published on this operation appear to be concerned mainly with

surgical methods and the frequency of bone healing, rather than with loss of

function and its causes.

The purpose of this study is to evaluate function of the arthrodesed hip

especially the relationship between position of the hip and its daily use.

The author studied arthrodesis of the hip clinically in 89 cases of arthrodesed

patients, admitted to the Orthopedic Department of Severance Hospital during the 14

years from June 1957 until May 1970. The author also studied 40 cases which

confirmed sound bony ankylosis of the hip by X-ray examination. The follow-up

included a careful inquiry into the patients ability to use the fixed hip in

various functions of daily life.

The results are as follows:

1. The average age of the patients at the time of operation was 16.9 years and

tuberculosis of the hip was the most common cause 83(93%) of arthrodesis.

2. The most common type of operation in this series was intraarticular

arthrodesis 67(75.3%), and the fusion rate was relatively good in intra &

extraarticular arthrodesis 20(85.5%).

3. The average length of follow-up was 16.2 years. The average position of the

arthrodesed hip was 37.7 degrees of flexion, 9.1 degrees of abduction and neutral

rotation. Actual shortening of the leg averaged 3.8cm.

4. The gait was poor in the group which had 5cm shortening of the leg and was in

43 degrees of flexion for the arthrodesed hip.

5. The ability to sit and defecate in the ordinary toilet was satisfactory when

there was 39 degrees of flexion or more for the arthrodesed hip.

6. 10 patients(25%) had back pain and 12 patients(30%) had mild scoliosis.

Average Ferguson angle was 34.3 degrees and the Line of Weight Thrust showed over

40 degrees of flexion.

7. The ideal hip position of arthrodiesis in Koreans was assumed to be under 40

degrees of flexion, some degrees of abduction and no rotation.

[영문]

The arthrodesis of the hip is the only certain method for eliminating pain and providing sability in young and middle aged adults. The first used arthrodesis in old congenital dislocation was reported by Heusmer, Lampugnani, and Alert as early as 1885 according to Nove-Joesearand.

The various papers published on this operation appear to be concerned mainly with surgical methods and the frequency of bone healing, rather than with loss of function and its causes.

The purpose of this study is to evaluate function of the arthrodesed hip especially the relationship between position of the hip and its daily use.

The author studied arthrodesis of the hip clinically in 89 cases of arthrodesed patients, admitted to the Orthopedic Department of Severance Hospital during the 14 years from June 1957 until May 1970. The author also studied 40 cases which

confirmed sound bony ankylosis of the hip by X-ray examination. The follow-up included a careful inquiry into the patients ability to use the fixed hip in various functions of daily life.

The results are as follows:

1. The average age of the patients at the time of operation was 16.9 years and tuberculosis of the hip was the most common cause 83(93%) of arthrodesis.

2. The most common type of operation in this series was intraarticular arthrodesis 67(75.3%), and the fusion rate was relatively good in intra & extraarticular arthrodesis 20(85.5%).

3. The average length of follow-up was 16.2 years. The average position of the arthrodesed hip was 37.7 degrees of flexion, 9.1 degrees of abduction and neutral rotation. Actual shortening of the leg averaged 3.8cm.

4. The gait was poor in the group which had 5cm shortening of the leg and was in 43 degrees of flexion for the arthrodesed hip.

5. The ability to sit and defecate in the ordinary toilet was satisfactory when there was 39 degrees of flexion or more for the arthrodesed hip.

6. 10 patients(25%) had back pain and 12 patients(30%) had mild scoliosis. Average Ferguson angle was 34.3 degrees and the Line of Weight Thrust showed over 40 degrees of flexion.

7. The ideal hip position of arthrodiesis in Koreans was assumed to be under 40 degrees of flexion, some degrees of abduction and no rotation.